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Journal of Nutritional Medicine (1992) 3. 145-148

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CASE REPORT

Nutritional Intervention for AIDS Patients

CHRIS M. READING BSc DpACSC MB BS FRANCP
P.O. Box 587, Dee Why, New South Wales 2099 Australia

A programme of investigation and treqtment is described in two cases of HIV- I infected male palients with AIDS symptomatology, who had been partially helped wilh AZT (Zidovudine). Under this programme, they were investigated for nutritional deficiencies qnd evidence of food and/or chemical sensitivities/intolerance which might aggravqte or contribute to their condition. Subsequent nututritional supplementation and dietary advice has produced signfficant improvement.
Keywords:

HIV, AIDS, vitamin and mineral supplements, food intolerance

CASE I

A Caucasian, age 45, HIV+ since 1986 and on AZT 100 mg3lday, with the following symptoms: emaciation, pallor, pale palmar creases, flattened soft nails with many transverse lines, anal fissures, haemorrhoids, coated tongue, monilia, bowel frequency (he was taking Salazopyrin 0.5 gm 4/day and had a history of ulcerative colitis), dry skin, glare intolerance, leg/feet cramps, painful stiff shoulders and painful hips (with a history of ankylosing spondylitis for which he took Voltaren@ (diclofenac sodium) at times). He also complained of muscle pains in his arms, lassitude, poor memory/concentration, insomnia, of feeling chronically anxious, and of dreaming rarely, without colour, apart from occasional nightmares. He had a purple skin lesion on the right

[-

lower leg.

Pathology
See

Table I

Results

On supplementation with B 1, B2, B6, phosphate and selenium, and by avoiding foods to which he had shown an allergic response, he has made a dramatic improvement. Whereas before treatment he had barely been able to swim one length of a pool, he can now swim 40 lengths, and his arm muscles have doubled in size. He has put on several kg in weight, and has energy. His mentation has also improved. His prognosis now
appears much more favourable.
t45

146
CASE 2

cHRrs M. READTNG

A Caucasian, age 33, showing a positive HIV-I infection 16 months previously, and taking AZT 100 mg 3/day and DDI 2 packets/day. High doses of AZT produced
nausea.

He was tall, very underweight and had a chronic headcold with both ears blocked. He had pruritis, sinusitis, numbness in his feet, which at times throbbed and hurt. He complained of depression, lassitude, poor memory/concentration, headaches/migraine, insomnia, chronic anxiety and low stress tolerance. His tongue was coated with yeast and showed numerous fissures. He also complained of muscle weakness, cracked lips, glare intolerance, haemorrhoids, constipation, cold intolerance and poor dream recall.
Pathology
See

Table I
was

Results

His diet was supplemented with Bl, 86, magnesium, selenium and zinc, and

allergy-free. He has also shown a dramatic improvement, with relief from most of his symptoms, weight gain and clear mentation. His prognosis would also appear to be much more favourable.
TABLE

l.

Pathology of the two AIDS patients

Reference range Case

Parameter Haematology

Case 2

Hb
RBC

13-18
4.5-'.7.0

tt2
4.1

wBc
Vitamins Vitamin Bl (TPP effect) Vitamin Bl (ETKA) Vitamin 82 (EBRA)

4.0-1 1.0 0-

4.8

123 4.2 3.4

5olo

210/o

16.2o/o

>140
0-300/o

104
360/o

103
24o/o

Vitamin B6 (EGOT) Vitamin B6 (P5P effect) Vitamin B12 (serum)

Minerals

>330
0-800/o

290
960/o

3r4
92.4o/o

t47-664
12.2-24.5 pmol/l 0.6-1.3 pmol/l 12.5-23.5 pmol/\ 0.084-0.12 pglml 0.8-1.5 pmol/l
0.45-2.20

1476

428

Zinc
Magnesium Copper
Selenium Phosphate

13.8

t2.4
1.1

0.81
17-5

0.076
0.7 |

20.7 0.089
1.18

Immune parameters IgM IsA

IgG
IgE

0.9-4'5
7.0- 19.0
20-1 50

3.2 5.9

1.8 5.7

t2.9
43 I :80

r4.4

not done

Pareital cell Abs Smooth muscle Abs Thyroglobulin Abs Microsomal Abs Synovial membrane Abs Bile duct Abs

<1:10 <1:10

<l:10 <l:10 <l:10

<1:10 <1:10
1

l:40
I :40 I :40

l:20
I :40
neg neg

l:20 l:20
neg

not done

not done
I :40

Anti-nerve Abs
Biochemistry Cortisol

93-690

858

not done

NUTRITION FOR AIDS PATIENTS

147

DISCUSSION The rationale for this programme of investigation and supplementation is based on the

following:

(a) Recent reports have described neuropathological changes (mamillary body atrophy, perivascular haemorrhagic lesions) seen with Wernicke's encaphalopathy in patients with AIDS [1-4]. B1 deficiency should be looked for and corrected [5]. (b) Vitamin 86 and other vitamin and trace element deficiencies should be looked for and corrected to prevent neurological changes [6]. (c) Toxic metals, such as aluminium, lead, cadmium and high levels of copper are known to cause neurological and joint problems, suppression of the immune system and many other problems. For this reason, toxic metal levels should be routinely checked in hair and blood. High levels reduce over time on extra vitamin C, zinc and
selenium and by avoidance of food allergies.

(d) Dysproteinaemia (such as raised IgM, known to be a determinant of HIV by diet. In my experience, raised IgM in coeliac disease and grain/yeast sensitivity/ intolerance reduce with a gluten/yeast-free diet. Raised IgA, in my experience. is commonly seen with allergy/intolerance (showing on BCFT and now also on ALCAT) to fractions of cow's milk, beef, eggs and yeast.
(e) Autoimmune disease is known to be associated with AIDS and with raised IgM conditions [7]. As with SLE patients [9], autoimmune disease should be looked for and treated with diet and nutrients.
disease progression [7, 8], and raised IgA) should be looked for and corrected/reduced

(f) Food and chemical sensitivities/intolerances should be avoided because they can

[0], affect mood and behaviour [11], cause malabsorption state and autoimmune disease [9], and allow the preferential absorption of toxic metals into the body, especially if low in Bl, 86, vitamin C, zinc or selenium
cause neuropsychiatric symptoms

t3l. In conclusion, with AIDS patients at increased risk of developing CNS lymphoma [14], systemic lymphoma, Burkitt's lymphoma, proneness to infection, chromosomal changes, malignant changes and neuropsychiatric disorders, it is my hope that the above two cases will encourage others to research nutritional intervention in the primary, secondary and tertiary prevention of AIDS I I 5]. It may be that such research could shed some light on the aetiology of HlV-associated enteropathy [ 6] and why toxic glycoproteins in foods and bacterial/viral/yeast capsules seem to aggravate the
112,

condition

[7].

Editors' Note: We have asked Dr Reading for a report on the progress of these patients

in

12 months time.

REFERENCES

tll

Dartyan DG, Vinters HV. Wernicke's encephalopathy in AIDS patient treated with Zidovudine.

Lancet 1987; l:919-20. t2l Foresti V, Confalonieri F. Wernicke's encephalopathy in AIDS. Lancet 1987; l:1499. t3l Lindboe CF, Loberg EM. Wernicke's encephalopathy in non-alcoholics: an autopsy study. J. Neurol Sci 1989; 90: 125-9. t4l Schwenk J, Gosztonyl G, Theiranf P, Iglesias J, Langer E. Wernicke's encephalopathy in two patients with acquired immunodeficiency syndrome. J Neurol 19901,7: 445-7. t5t Butterworth RF, Gaudreau C, Vincelette J, Bourgault A, Lamothe F, Nutini A. Thiamine deficiency in AIDS. Lancet l99l; 338: 1086.

148

CHRIS M. READING

[6]

[7] [8] [9]

[10] [11] [12]

Werbach MR. Nutritional influences on Illness: A Sourcebook of Clinical Research. Tarzana, CA: Third Line Press, 1988. Simmonds P, Beatson D, Cuthbert RJG, Watson H, Reynolds B, Peutherer JF, Parry JV, Ludlam CA, Steel CM. Determinants of HIV disease progression: six-year longitudinal study in the Edinburgh haemophilia/HlV cohort. Lancet 1991;338: ll59-63. Pizzolo G, Vinante F, Morosato L, De Sabata C, Sinicco A, Raiteri R, Agostini C, Semonzato G. Determinants of HIV disease progression. Lancet 19921'339: 130. Reading CM. Dietary intervention in systemic lupus erythematosis: 4 cases of clinical remission and reversal of abnormal pathology. Int Clin Nutr Rev. 1985; 5(a): 166-6. McGovern JJ, Lazaroni JL, Saifer P, Levin AS, Rapp DJ, Gardner RW. Clinical evaluation of the major plasma and cellular measures of immunity. Orthomolecular Psychiatry 1983; 12(1): 60-7 1. Cheraskin E, Allen JJ, Zavlk JS. Therapeutic implications of cytotoxic testing. Orthomolecular Psychiatry 1985; 14(2): 128-135. Prasad R et al. The effect of 86 and B I deficiencies on the uptake of calcium, zinc and cadmium.

Ann Nutr Metabolism 1982;26: 324-30. Zelenko V. Correlation between selenium and mercury in man following exposure to inorganic mercury. Nature 1975; 254:285. [4] MacMahon EME, Glass JD, Hayward SD, Mann RB, Becker PS, Charache P, McArthur JC, Ambinder RF. Epstein-Barr Virus in AlDS-related primary central nervous system lymphoma. Lancet l99l; 338: 969-73, 979-81. [15] Malcolm JA, Sutherland DC. HIV and Nutrition. Lancet 1991; 338: 760. [16] HlV-associated Enteropathy (Editorial) Lancet 1989;2: 777-8. [1 7] Pettoello-Mantovani M, Casadevall A, Kollman JR, Rubinstein A, Goldstein H. Enhancement of HIV-1 infection by the capsular polysacchride of cryptococcus neoformans. Lancel 1992;339:.

[13] Kosta L, Byrne AR,

2t-3.